HomeMy WebLinkAboutL 12203 P 516BARGAIN AN-~D SAL~ DI~I:D WIT~ COVENANT AG~ ACTS (INDPv'IDUA~, OR CORPORATION)
STANDARD NY~T~ ]~O~M ~
· ~ tl'~ ~. plot. ph~c~ or ~mgccl ofhu~ ~ U~e Imildings and improvemea~ t~ (we~ted,
HERETO AND IdADE A PART
't~m ~amor ~in is &~ same per'~on ,.-~ the 8rnnle~ hs ~ dazzl L~aad rec~ I/4~ ia
L~he~ 12011 cp
~clS ~nl~ ~e above ch~rtbed pm~i~es m Ihe c~nl~r llne. shem~,
~liAV~AN~ 7~ H~/,.D d~ Im~ heroin Brm~ unlu lbo ~ofd. msuoad Im~ dm Ist~ or
su~ses ar~ ~sig~s of sh~ pa~y of Um seecmd part tomv~.
fro' n~, od~' pm'pine
STATE OF NEW YORK
OK}LINTY OF SUFFOLK
~ ~dual(s) acted,
Te
KILUA~N
E~421
Comm.
Cenill~l
;~ oo
P
~TMd
~ Scc~on Z)~uck Lot
02028440 ~OOO 07000 OSO0 029000
° Suffolk
IT, is pa~ fores ~ ot'¢~ allached
II~IIIIIII~BIIIIEII El!
070.00 09,00
~t33.9,, 000.~00
08t3/&13003
OAtS&s36 BM
I)00013203
5~
037.000
II.S, O0
$~LS.O0 ago
(l~tl ~ O0 let)
$0.00 mt)
lO.O0
380. O0
(F&, 7Bll. O0
FOR COUNT~ USE ONLY
C1. SWIS Code
PLEASE TYPE OR PRESS FIRMLY WHEN WR-IT~NG ON FORM
INSTRUCTIONS: http://www.orps.state.ny.us of PHONE (518) 473-7222
REAL PROPERTY TRANSFER REPORT
STATE OF NEW YORK
STATE BOARD OF REAL PROPERTY SERVICES
RP - 5217
I Brettstadt Court
PROPERTY I~MATtON
1. Property I 290
Location
STREET NUMBER
Southoid
{ 11971
VILLAGE
ZIP CODE
Hat.are t A,
3. Tax
Billing
Address
LAST NAME / COMPANY
Indicate where future Tax Bills are to be sent
if other than buyer address (at bottom of form)
FIRST NAME
LAST NAME / COMPANY
FIRST NAME
I
STREET NUMBER AND STREET NAME
Cl~' OR TOWN
I , I
STATE
ZIP CODE
4. Indicate the number of Assessment )
Roll parcels transferred on the deed I , I # of Parcels OR Par[ of a Parcel
5. Deed
Propecty I {xt JORI .... , , I
Size FRONT FEET DEPTH ACRES
6. Seller I dohu ou I
(Only if Part of a Parcel) Check as they apply:
4A. Planning Board with Subdivision Authority Exists []
4~. Subdivision Approval was Require~ for Transfer []
4C. Parcel Approved for Subdivision with Map Provided []
Name LAST NAME / COMPANY
FIRST NAME
LAST NAME / COMPANY FIRST NAME
7. Check the box below which most accurately describes the use of the property at the time of sale:
iOne Family Residential
2 or 3 Family Residential
Residential Vacant Land
Non-Residential Vacant Land
11. Sale Contract Date
12. Date of Sale / Transfer
Agricultural I [] Community Service
Commercial J ~ Industrial
Apartment g~ Public Service
Entertainment/Amusement El I Forest
16 /7 /02 I
Month Day Year
I 7 o2 I
Month Day Year
Check the boxes below as they apply:
8. Ownership Type is Condominium []
9. New Construction on Vacant Land []
10A. Property Located within an Agricultural District []
10B. Buyer received a disclosure notice indicating []
that the property is in an Agricultural District
15. Check one or more of these c~ndifions as applicable to transfer:
A
B
C
D
E
Sale BeWveen Relatives or Former Relatives
Sale Between Belated Companies or Partners in Business
One of the Buyers is also a Sefler
Buyer or Seffer is Government Agency or Lending Institution
Deed Type not Warranty or Bargain and Sale (Specifl/Below)
Sale of Fractional or Less than Fee Interest (Specify Below)
13. Full Sa{e PriceI , , , 3 , I , 9 , 0 , 0 , 0 , 0 , 0 I
(Full Sale Price is the total amount paid for the property including personal property, [
This payment may be in the form of cash, other property or goods, or the assumption of J
modgages or other obligatlons.) Please round to the nearest whole dollar amount,
14. Indicate the value of personal I , , , , , , I 0 I 0 I
property included in the sale ~ ~ ·
ASSESSMENT INFORMATION * Data should reflect the latest Final Assessment Roll and Tax Bill
I ~) ,J-I 17. Total Assessed Value {of all parcels in transfer) I
16.
Year
of
Assessment
Roll
from
which information taken
18. Property Class i2,( ,i~l-L.J 19. School Dietrict Name I &~)':-
Signigcant Change in Proper~ Between Taxable Status and Sale Dates
Sale of Business is Included in Sale Price
Other Unusual Factors Affecting Sale Price (Specify Below}
None
20. Tax Map Identifier(si / Roll Identifier(s) (If more than four, attach sheet with additional identifier(s))
1000-070.00-09.00-O27.000
I
I
I CERT, ,CA ,O. I
I certify that all of the items of information entered on this form are true and correct (to the best of my knowledge and belief) and I understand that the making
of any willful false statement of material fact herein will subject me to the provisions of the penal law relative to the making and IUing of false instruments.
BUYER
SELLER
BUYER'S A'I'rORNEY
FtRST NAME
AREA CODE
TELEPHONE NUMBER
ICITY/TOWN ASSESSOR
COPY